Abstract:
BACKGROUND:Multi-injection targeted intracluster injection ultrasound-guided supraclavicular brachial plexus block has been advocated to provide a faster onset of anaesthesia compared with a double injection technique. By placing the needle within clusters of hypoechoic structures, corresponding to neural tissue, this technique may increase needle trauma and the incidence of nerve injury. This study assessed the rate of sub-perineural needle placement with a single intracluster brachial plexus injection in the supraclavicular fossa of human cadavers. METHODS:A single ultrasound-guided intracluster brachial plexus injection was performed bilaterally at the supraclavicular fossa on 21 lightly embalmed clinical grade cadavers. Using an in-plane technique, an echogenic needle was positioned to target the middle or lower trunk 'cluster', where 0.2 ml black India ink was injected. An effort was taken to avoid the hypoechoic structures with the needle tip. Tissue samples were assessed histologically by two experienced reviewers. RESULTS:All 42 injections were sonographically assessed to be within the 'main cluster'. Ink was extra-epineural in 13/41 (32%), sub-epineural but outside perineurium in 18/41 (44%), and sub-perineural in 10/41 sections (24%; 95% confidence interval, 13-41%). The histology from one injection was uninterpretable. Of the 10 sub-perineural deposits, the ink was intrafascicular in nine sections. CONCLUSIONS:We observed a high rate of sub-perineural injection with a single intracluster injection. Thus the targeted intracluster injection supraclavicular block cannot be recommended until further evidence is available regarding the safety of this technique.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Retter S,Szerb J,Kwofie K,Colp P,Sandeski R,Uppal Vdoi
10.1016/j.bja.2019.01.006subject
Has Abstractpub_date
2019-06-01 00:00:00pages
776-781issue
6eissn
0007-0912issn
1471-6771pii
S0007-0912(19)30018-2journal_volume
122pub_type
杂志文章abstract::Thirty-two patients received lumbar extradural anaesthesia for elective Caesarean section. The results obtained from this series were compared with those from a similar (control) group of parturients who received general anaesthesia. The extradural group (mothers and infants) were metabolically acidaemic relative to c...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/51.4.367
更新日期:1979-04-01 00:00:00
abstract::The rapid detection and evaluation of patients presenting with perioperative neurological dysfunction is of great clinical relevance. Biomarkers have been defined as biological molecules that can be used as an indicator of new onset or progression of a biological process or effect of treatment. Biomarkers have become ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aer338
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:Dexmedetomidine has been proposed as a perineural local anaesthetic (LA) adjunct to prolong peripheral nerve block duration; however, results from our previous meta-analysis in the setting of brachial plexus block (BPB) did not support its use. Many additional randomized trials have since been published. We ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,meta分析,评审
doi:10.1093/bja/aew411
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:Owing to complexities of measuring dead space, ventilatory failure is difficult to quantify in critical care. A simple, novel index called ventilatory ratio (VR) can quantify ventilatory efficiency at the bedside. The study objectives were to evaluate physiological properties of VR and examine its clinical a...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aet283
更新日期:2014-01-01 00:00:00
abstract::A randomized, double-blind study of 38 patients undergoing total knee replacement was undertaken to compare the efficacy and respiratory effects of low-dose spinal morphine and patient-controlled i.v. morphine against patient-controlled i.v. morphine alone. Patients received either morphine 0.3 mg or saline 0.3 ml wit...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/85.2.233
更新日期:2000-08-01 00:00:00
abstract::We have developed a simple, reliable method for rapid analysis of the partial pressure of volatile anaesthetic agents, based on a two-stage, head-space analysis. It is designed to solve the problems associated with reduced solubility of modern anaesthetics. After equilibration and analysis of a 2-ml sample of blood at...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/78.4.449
更新日期:1997-04-01 00:00:00
abstract::Units for the investigation of susceptibility to malignant hyperthermia (MH) were set up in Denmark in 1977 and in Sweden in 1981. Two hundred and ten patients from 76 families have been investigated. The diagnosis of MH susceptibility (MHS) was made by in vitro exposure of muscle from vastus medialis to halothane and...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/56.11.1183
更新日期:1984-11-01 00:00:00
abstract::The influence of sodium nitroprusside (SNP) on mitochondrial respiration was examined in rat liver mitochondria. The addition of SNP 1 mmol litre-1 during state 3 respiration inhibited the oxygen uptake by 63.4%. A mixture of SNP 1 mmol litre-1 and glutathione (GSH) 1 mmol litre-1 inhibited the oxygen uptake more mark...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/49.12.1239
更新日期:1977-12-01 00:00:00
abstract::This study was designed to observe the effects of i.v. fluid infusion on uterine activity during normal labour in women receiving an extradural block. Thirty-four women in spontaneous labour at term gestation were allocated randomly and prospectively to one of three i.v. pre-extradural fluid load groups: group A, no f...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/77.5.632
更新日期:1996-11-01 00:00:00
abstract::The calculation of pharmacokinetic parameters after a bolus injection of fentanyl allowed an i.v. infusion scheme which guarantees analgesia for the entire duration of surgery, with the advantage of steady plasma concentration and body content. In the initial phase after bolus injection, the serum concentration decrea...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/52.10.1021
更新日期:1980-10-01 00:00:00
abstract::In order to clarify the relative contribution of hepatic metabolism to the short term disposition of methohexitone, we have measured hepatic blood flow during induction of anaesthesia with a 1.5-mg kg-1 i.v. bolus dose of methohexitone. Median hepatic clearance was 1.01 litre min-1 and hepatic extraction 87%. As a con...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/69.5.478
更新日期:1992-11-01 00:00:00
abstract:BACKGROUND:Transitions into and out of the anaesthetised state exhibit resistance to state transitions known as neural inertia. As a consequence, emergence from anaesthesia occurs at a consistently lower anaesthetic concentration than induction. Motivated by stochastic switching between discrete activity patterns obser...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2018.02.035
更新日期:2018-07-01 00:00:00
abstract::This study has examined the effect of hydration on immediate recovery from anaesthesia in two groups of 15 patients undergoing therapeutic abortion. A standard anaesthetic technique was administered. Patients in group I received no preoperative fluid; those in group II received, before anaesthesia, 20 ml kg-1 of 4% gl...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/68.6.576
更新日期:1992-06-01 00:00:00
abstract::In order to evaluate simple means of determining the rate of recovery after general anaesthesia, the usefulness of the critical flicker fusion threshold test, the Maddox wing apparatus and the visual analogue scale were compared. The postanaesthetic recovery score was used as a reference. Two patient groups (n = 15 in...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/59.8.978
更新日期:1987-08-01 00:00:00
abstract::The determination of blood flow, i.e. cardiac output, is an integral part of haemodynamic monitoring. This is a review on noninvasive continuous cardiac output monitoring in perioperative and intensive care medicine. We present the underlying principles and validation data of the following technologies: thoracic elect...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aeu447
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:Fluid administration to increase stroke volume index (SVi) is a cornerstone of haemodynamic resuscitation. We assessed the accuracy of SVi variation during a calibrated abdominal compression manoeuvre (ΔSVi-CAC) to predict fluid responsiveness in children. METHODS:Patients younger than 8 yr with acute circu...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2018.06.030
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:The AirWay Scope (AWS) is a fibreoptic device that allows for intubation without alignment of the oral, pharyngeal, and tracheal axes. It may be useful for patients with an unstable cervical-spine (C-spine) or when C-spine movement is undesirable. This study was conducted to fluoroscopically evaluate upper C...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aen207
更新日期:2008-10-01 00:00:00
abstract::The effects of the i.v. infusion of insulin, 70 mu. kg-1h-1 for the first 60 min and 35 mu. kg-1h-1 subsequently, on the metabolic and endocrine responses to gynaecological surgery were investigated. In comparison with a control group of patients, the insulin infusion caused a marked decrease in circulating glucose, n...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/55.10.939
更新日期:1983-10-01 00:00:00
abstract::Sleep disordered breathing is a common problem affecting all age groups, particularly in association with certain other medical conditions and syndromes. The pathological consequences of the disorder may be severe, with significant implications for the perioperative management of sufferers. Research into the effects o...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/86.2.254
更新日期:2001-02-01 00:00:00
abstract::We have studied the haemodynamic and myocardial effects of propofol-fentanyl anaesthesia in 12 patients undergoing coronary artery bypass surgery during the pre-bypass period. The induction dose of propofol was 1.5 mg kg-1 and mean infusion rate during maintenance was 4.48 mg kg-1 h-1 (range 1.87-7.24 mg kg-1 h-1). Th...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/66.4.504
更新日期:1991-04-01 00:00:00
abstract::The effects of Org NC 45 and pancuronium bromide on heart rate and arterial pressure were studied in anaesthetized man. A bolus of either Org NC 45 0.1 mg kg-1 or pancuronium 0.1 mg kg-1 was administered to lightly anaesthetized unstimulated subjects. Following Org NC 45 heart rate decreased in the majority of subject...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/54.4.435
更新日期:1982-04-01 00:00:00
abstract::Temazepam elixir 30 mg by mouth was compared with i.v. Diazemuls titrated to a maximum dose of 20 mg in a double-blind study of 50 patients undergoing elective minor oral surgery. The treatments produced a similar reduction in anxiety score and similar degrees of patient relaxation and co-operation. The diazepam group...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/60.1.18
更新日期:1988-01-01 00:00:00
abstract::We have investigated the effects of 9.5% and 14.1% MAC concentrations of isoflurane on some psychometric measurements. Both concentrations depressed peak saccadic velocity (P < 0.01), choice reaction time (P < 0.05) and visual analogue scores for sedation (P < 0.05), but not the critical flicker fusion threshold. The ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/71.6.839
更新日期:1993-12-01 00:00:00
abstract::We have determined the influence of 0.1 minimum alveolar concentration (MAC) of sevoflurane on ventilation, the acute ventilatory response to a step change in end-tidal carbon dioxide and the ventilatory response to sustained hypercapnia in 10 healthy adult volunteers. Subjects undertook a preliminary 10-min period of...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/83.2.204
更新日期:1999-08-01 00:00:00
abstract:BACKGROUND:The low and moderate doses of dexmedetomidine reduce arterial pressure and heart rate (HR), suggesting attenuation of sympathetic activity and dominance of cardiac-vagal activity. These autonomic responses under dexmedetomidine sedation may attenuate cardiovascular reflex responses to temporal reduction in a...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aep210
更新日期:2009-10-01 00:00:00
abstract::A 38-yr-old woman with an atrial septum defect and Eisenmenger syndrome was scheduled for a lung biopsy via thoracoscopy during one-lung ventilation. Fluids were given to increase central venous pressure to 8 mm Hg, an epidural catheter was inserted at the sixth thoracic intervertebral space and ropivacaine 0.3%, 6 ml...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeh104
更新日期:2004-04-01 00:00:00
abstract::Cardiac rate and rhythm were compared in 60 patients having dental extractions under conventional general anaesthesia using halothane, enflurane or isoflurane to supplement nitrous oxide in oxygen. The incidence of arrhythmia was higher in the halothane group when compared with both the enflurane (P less than 0.05) an...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/57.5.476
更新日期:1985-05-01 00:00:00
abstract::In this report we present the case of a 77-yr-old man who underwent resection of the upper lobe of the left lung for a carcinoma, six weeks after percutaneous transluminal coronary angioplasty (PTCA) with stenting of the left anterior descending (LAD) and circumflex coronary arteries. Antiplatelet therapy with clopido...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeh110
更新日期:2004-05-01 00:00:00
abstract:BACKGROUND:The observation that patients presenting for bariatric surgery had a high incidence of neuromuscular blocking agent (NMBA) anaphylaxis prompted this restricted case-control study to test the hypothesis that obesity is a risk factor for NMBA anaphylaxis, independent of differences in pholcodine consumption. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2020.12.018
更新日期:2021-01-13 00:00:00
abstract::We present a case of fatal cardiac tamponade that occurred in association with a peripherally inserted central catheter (PICC) inserted from the right antecubital fossa. Migration of the catheter from the right atrium within 24 h of insertion lead to the administration of a potassium-enriched sodium chloride solution ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aem181
更新日期:2007-09-01 00:00:00